Glutamine - its benefits and side effects.

Glutamine
March 2009

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Over the last 10 years clinical trials of glutamine supplementation in
critical illness have shown benefit with regard to mortality, length of stay,
and infectious morbidity. It appears that dose and route of administration
clearly influence the benefit observed from glutamine administration, with
high-dose, parenteral glutamine demonstrating an advantage over
low-dose, enteral glutamine. [5]

Glutamine is normally considered to be a nonessential amino acid.
However, recent
studies have provided evidence that glutamine may become
"conditionallyessential" during inflammatory conditions such as infection
and injury. [4]

Under appropriate conditions, glutamine is essential for cell proliferation,
that it can act as a respiratory fuel and that it can enhance the function of
stimulated immune cells. [4] L-glutamine operates as a nitrogen shuttle,
taking up excess ammonia and forming urea. It can contribute to the
production of other amino acids, glucose, nucleotides, protein, and
glutathione. Glutamine is primarily formed and stored in skeletal muscle
and lungs, and is the principal metabolic fuel for small intestine
enterocytes, lymphocytes, macrophages, and fibroblasts. [3]

Potential Health Benefits of L-glutamine

L-glutamine has been used to improve glutathione levels and increase
the lean body mass in HIV infection. [2]

Supplemental use of glutamine, either in oral, enteral, or parenteral form,
increases intestinal villous height, stimulates gut mucosal cellular
proliferation, and maintains mucosal integrity. It also prevents intestinal
hyperpermeability and bacterial translocation, which may be involved in
sepsis and the development of multiple organ failure. [3]

L-glutamine use has been found to be of great importance in the
treatment of trauma and surgery patients, and has been shown to
decrease the incidence of infection in these patients. [3]

Cancer patients often develop muscle glutamine depletion, due to uptake
by tumors and
chronic protein catabolism. Glutamine supplementation may be helpful in
offsetting this depletion. The use of glutamine with cancer chemotherapy
and radiotherapy seems to prevent gut and oral toxic side-effects, and
may even increase the effectiveness of some chemotherapy drugs. [3]
Researchers developed diazo analogs of L-glutamine as anticancer
agents in lab testings. [1]

Glutamine may also stimulate the growth of some tumors. [3]

[1] Catane R, Von Hoff DD, Glaubiger DL, Muggia FM. Azaserine, DON,
and azotomycin: three diazo analogs of L-glutamine with clinical antitumor
activity. Cancer Treat Rep. 1979 Jun;63(6):1033-8. [2] Patrick L.
Nutrients and HIV: part three - N-acetylcysteine, alpha-lipoic acid,
L-glutamine, and L-carnitine. Altern Med Rev. 2000 Aug;5(4):290-305. [3]
Miller AL. Therapeutic considerations of L-glutamine: a review of the
literature. Altern Med Rev. 1999 Aug;4(4):239-48. [4] Newsholme P. Why
is L-glutamine metabolism important to cells of the immune system in
health, postinjury, surgery or infection? J Nutr. 2001 Sep;131(9
Suppl):2515S-22S; discussion 2523S-4S. [5] Kelly D, Wischmeyer PE.
Role of L-glutamine in critical illness: new insights. Curr Opin Clin Nutr
Metab Care. 2003 Mar;6(2):217-22.